Short- and Long-Term Outcome of Children With Congenital Complete Heart Block Diagnosed In Utero or as a Newborn

Abstract

Despite early pacing, CHB carries high mortality during the first 12 months of life. High incidences of DCM and associated heart defects indicate close echocardiographic monitoring of all children with CHB.

The cerebroplacental Doppler ratio predicts postnatal outcome in fetuses with congenital heart block

“…2 This condition also results in significant morbidity with one group reporting 27% of fetuses developing fetal hydrops, 21% developing cardiac failure without hydrops and 53% requiring pacemaker therapy in the newborn period. 4 Premature delivery is one of the most important risk factors for mortality, with one large series showing 52% mortality in infants born at less than 34 weeks gestational age compared to 8% mortality in infants born at or after 34 weeks gestational age. 2 Other risk factors of poor fetal outcome are low ventricular rate, hydrops fetalis, low birth weight, male sex and EFE of the ventricle.…”

“…2 Other risk factors of poor fetal outcome are low ventricular rate, hydrops fetalis, low birth weight, male sex and EFE of the ventricle. 4,5 Fetuses exposed to the maternal autoantibodies Ro and La can develop EFE, and its presence is associated with ventricular dysfunction, independent of bradycardia. 12 Over the past several years, there have been significant advances in the prenatal diagnosis and management of fetuses with autoimmune-mediated CCHB.…”

“…Many fetuses ultimately require ventricular pacing for poor cardiac output shortly after delivery. [2][3][4][5] Low ventricular rate, hydrops fetalis, low birth weight, male sex, endocardial fibroelastosis (EFE) of the ventricle and gestational age less than 34 weeks are risk factors for a poor fetal outcome. 2,4,5 Prenatal monitoring of fetuses with CCHB remains a significant challenge.…”

“…[2][3][4][5] Low ventricular rate, hydrops fetalis, low birth weight, male sex, endocardial fibroelastosis (EFE) of the ventricle and gestational age less than 34 weeks are risk factors for a poor fetal outcome. 2,4,5 Prenatal monitoring of fetuses with CCHB remains a significant challenge. Fetuses with deteriorating cardiac function may not always exhibit the lowest heart rate, 6 and other ultrasonographic markers of poor cardiac output, including standard Doppler indices, can be unreliable in the face of substantial bradycardia.…”

Outcomes of fetal echocardiographic surveillance in anti‐SSA exposed fetuses at a large fetal cardiology center

“…While only 1-2% of exposed fetuses develop third-degree atrioventricular (AV) block, fetuses with AV block and cardiomyopathy suffer high morbidity and mortality. [1][2][3][4] Current fetal echocardiographic surveillance methods are costly and do not accurately predict which fetuses will develop progressive AV block and cardiomyopathy. On the basis of the possibility of poor outcome if AV block occurs, fetal echocardiography is recommended for maternal anti-SSA/anti-SSB antibodies.…”